title: Multiple sclerosis incidence associated with the soil lead and arsenic concentrations in Taiwan.
abstract: BACKGROUND
  Few studies in the world have assessed the incidence of multiple sclerosis (MS) with soil heavy metal concentrations. We explored the association of soil heavy metal factors and the MS incidence in Taiwan.
  
  
  METHODS
  There were 1240 new MS cases from the National Health Insurance Research Database and were verified with serious disabling disease certificates, 1997-2008. Soil heavy metal factors records included arsenic, mercury, cadmium, chromium, copper, nickel, lead and zinc in Taiwan from 1986 to 2002. Spatial regression was used to reveal the association of soil heavy metals and age- and gender-standardized incidence ratios for townships by controlling sunlight exposure hours, smoking prevalence and spatial autocorrelation.
  
  
  RESULTS
  The lead (Pb) concentration in the soil positively correlated with the township incidence; on the other hand, the arsenic (As) concentration in soil negatively correlated with the township incidence and when found together controlled each other. The positive correlation of lead (Pb) predominated in males, whereas the negative correlation of arsenic (As) in soil predominated in females.
  
  
  CONCLUSIONS
  We conclude that exposure to lead (Pb) in soil positive associated with incidence of MS in Taiwan, especially in males. Exposure to arsenic (As) in soil negative associated with MS in Taiwan, especially in females.
authors.affiliation: Neurology, Neurological Institute, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
authors.forename: Ching-Piao
authors.initials: CP
authors.lastname: Tsai
authors.forename: Charles Tzu-Chi
authors.initials: CT
authors.lastname: Lee
mesh_terms: D001151:Arsenic / Q000032:analysis / Q000633:toxicity*; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D015994:Incidence; D007854:Lead / Q000032:analysis / Q000633:toxicity*; D008297:Male; D009103:Multiple Sclerosis / Q000139:chemically induced / Q000453:epidemiology*; D009313:National Health Programs; D012907:Smoking / Q000453:epidemiology; D012989:Soil Pollutants / Q000032:analysis / Q000633:toxicity*; D013472:Sunlight; D013624:Taiwan / Q000453:epidemiology
chemical_list: D012989:Soil Pollutants; D007854:Lead; D001151:Arsenic